Endoscope with regidizable introducer sheath

Abstract

An endoscope with guiding apparatus is described herein. A steerable endoscope is described having an elongate body with a manually or selectively steerable distal portion, an automatically controlled portion, a flexible and passively manipulated proximal portion, and an externally controlled and manipulatable tracking rod or guide. The tracking rod or guide is positioned within a guide channel within the endoscope and slides relative to the endoscope. When the guide is in a flexible state, it can conform to a curve or path defined by the steerable distal portion and the automatically controlled portion. The guide can then be selectively rigidized to assume that curve or path. Once set, the endoscope can be advanced over the rigidized guide in a monorail or “piggy-back” fashion so that the flexible proximal portion follows the curve held by the guide until the endoscope reaches a next point of curvature within a body lumen.

1 - 34 . (canceled)  
     
     
         35 . A method of advancing an instrument along an arbitrary path, comprising: 
 selectively steering a distal portion of the instrument to assume a selected shape along an arbitrary path;    advancing an introducer sheath along the instrument such that a portion of the introducer sheath conforms to and assumes the selected shape; and    maintaining a position of the introducer sheath while advancing the instrument along the introducer sheath such that a proximal portion of the instrument assumes the selected shape defined by the introducer sheath, wherein the introducer sheath is freely slidable along the length of the instrument such that advancing of the instrument along the introducer sheath is unconstrained.    
     
     
         36 . The method of  claim 35  wherein prior to advancing the introducer sheath along the instrument, further comprising advancing the instrument distally while configuring a controllable portion of the instrument to assume the selected shape of the distal portion, wherein the controllable portion is proximal of the distal portion.  
     
     
         37 . The method of  claim 35  further comprising measuring a depth change of the instrument while advancing the instrument distally.  
     
     
         38 . The method of  claim 37  further comprising incrementing a current depth by the depth change.  
     
     
         39 . The method of  claim 35  further comprising releasing the position of the introducer sheath and further advancing the introducer sheath along the instrument.  
     
     
         40 . The method of  claim 35  further comprising withdrawing the introducer sheath from the instrument.  
     
     
         41 . The method of  claim 35  wherein the distal portion of the instrument and a distal portion of the introducer sheath are adjacent.  
     
     
         42 . The method of  claim 35  wherein the distal portion of the instrument selectively assumes a second shape when the instrument is advanced within the introducer sheath.  
     
     
         43 . The method of  claim 42  further comprising advancing at least one additional introducer sheath along the instrument such that the additional introducer sheath conforms to and assumes the second shape.  
     
     
         44 . The method of  claim 43  further comprising rigidizing the additional introducer sheath such that the second shape is maintained by the additional introducer sheath.  
     
     
         45 . The method of  claim 35  wherein maintaining the position of the introducer sheath comprises rigidizing the introducer sheath such that the introducer sheath rigidly assumes a position of the selected shape.  
     
     
         46 . The method of  claim 45  wherein rigidizing the introducer sheath comprises applying tension to a tensioning member disposed within the introducer sheath such that a plurality of adjacent segments comprising the introducer sheath are compressed.  
     
     
         47 . The method of  claim 45  wherein rigidizing the introducer sheath comprises applying a vacuum force within a lumen defined within the introducer sheath such that a plurality of adjacent segments comprising the introducer sheath are compressed.  
     
     
         48 . An apparatus for insertion into a body cavity, comprising: 
 an elongate body having a proximal portion and a selectively steerable distal portion and defining a lumen therebetween, the steerable distal portion being configurable to assume a selected shape along an arbitrary path;    an introducer sheath having a proximal section, a distal section, and a length therebetween, the introducer sheath being slidably disposed without constraint along the length for selectively supporting the body, wherein the introducer sheath is configured to conform to and selectively maintain the selected shape assumed by the steerable distal portion, and    wherein the proximal portion of the elongate body when advanced distally is configured to conform to the selected curve maintained by the introducer sheath.    
     
     
         49 . The apparatus of  claim 48  further comprising a controllable portion located proximally of the distal portion, wherein the controllable portion is configured to propagate the selected shape along the controllable portion.  
     
     
         50 . The apparatus of  claim 48  wherein the selectively steerable distal portion is configurable via a control located externally of the body cavity.  
     
     
         51 . The apparatus of  claim 48  wherein the proximal portion comprises a flexible tubular member.  
     
     
         52 . The apparatus of  claim 49  wherein the controllable portion comprises a plurality of pivotally connected segments.  
     
     
         53 . The apparatus of  claim 52  wherein each of the segments comprises an actuator for propagating the selected shape along the controllable portion.  
     
     
         54 . The apparatus of  claim 53  wherein the actuator comprises a type of motor selected from the group consisting of pneumatic, hydraulic, electromechanical motors, and drive shafts.  
     
     
         55 . The apparatus of  claim 52  wherein the controllable portion comprises at least two pivotally connected segments.  
     
     
         56 . The apparatus of  claim 48  wherein the introducer sheath is configured to assume the selected shape when the introducer sheath is in a flexible state and wherein the introducer sheath is further configured to maintain the selected shape when the introducer sheath is in a rigidized state.  
     
     
         57 . The apparatus of  claim 56  wherein the introducer sheath is configured to selectively rigidize along the length of the introducer sheath to maintain the selected shape in the rigidized state.  
     
     
         58 . The apparatus of  claim 56  wherein the proximal section of the introducer sheath is in communication with an introducer sheath controller for selectively rigidizing the introducer sheath along its length.  
     
     
         59 . The apparatus of  claim 56  wherein the introducer sheath comprises a plurality of adjacent segments each defining a channel therethrough such that a common channel is defined through the length of the introducer sheath.  
     
     
         60 . The apparatus of  claim 59  further comprising a tensioning member disposed within the common channel such that applying a force to the tensioning member compresses the adjacent segments together.  
     
     
         61 . The apparatus of  claim 59  wherein the introducer sheath is configured to maintain a position of adjacent segments relative to each other upon applying a vacuum force within the common channel.  
     
     
         62 . The apparatus of  claim 48  further comprising an obstruction located within the lumen distally of the introducer sheath for preventing contamination of the introducer sheath.  
     
     
         63 . The apparatus of  claim 62  wherein the obstruction is selectively removable from a passageway of the lumen.  
     
     
         64 . The apparatus of  claim 63  wherein the obstruction comprises a trap or an expandable balloon.  
     
     
         65 . The apparatus of  claim 48  further comprising at least one additional introducer sheath having a proximal section, a distal section, and a length therebetween, the additional introducer sheath also being slidably disposed within the elongate body and being configured to conform to and selectively maintain an additional selected curve assumed by the steerable distal portion.  
     
     
         66 . The apparatus of  claim 48  further comprising a tubular covering disposed over at least a majority of the length of the elongate guide.